On Thursday, the Health and Human Services committee of the South Dakota House killed a bill that would have protected the right of parents to refuse to consent to medical or psychological treatment for a child suffering from gender dysphoria if the treatment “would induce, confirm, or promote the child’s belief that the child’s sex or gender identity is different from the child’s sex presented at birth.” Proposed House Bill 1205 also provided that “no public authority or official of this state may take any adverse action against a parent for exercising this right.”

That such a simple affirmation of parental rights could not clear a committee in this solidly red state should terrify parents, as it lays bare transgender activists’ plan: use the government to force parents to affirm a false sex for their child, agree to hormone blockers, and accept a transition to their son or daughter’s preferred gender. If parents refuse? Removal of the child from the family, due to alleged medical neglect.

We are already seeing the first two waves of this strategy, according to Dr. Michelle Cretella, executive director of the American College of Pediatricians. The first wave began in 2016 in the divorce and child custody setting, Cretella explained.

“I first began hearing from distraught parents in this situation in 2016 and in 2017, I heard from seven families in as many different states in this situation. In all but one case the child was a 15 year-old girl who never had any sexual identity confusion prior to her parent’s divorce,” Cretella said. “The other case involved 4-year-old triplet boys whose mother desperately wanted a girl. The mother was a psychologist herself and had cross-dressed one of the boys for two years, insisting that it was his idea. In each of the seven cases the guardian ad litems and judges removed the right to medical consent and/or custody from the parent who objected to transition with puberty blockers and hormones.”

The Second Wave

We have since moved on to the second wave, Cretella told The Federalist. “The second wave is going on now, with emergency room staff, therapists, or doctors reporting parents to Child Protective Services who refuse to affirm their child’s false gender.”

More recently, Cretella explains, she has heard from two sets of parents who were accused of being “abusive parents” for refusing to consent to hormone treatments for their teen children. In one case, the parents sought treatment for their son’s suicidal depression. Their son was adopted out of an abusive family, had a long history of depression and anxiety, had been in therapy in the past, was on medications, and never had any sign of gender dysphoria.

Nevertheless, the emergency room physician at the children’s hospital, after interviewing him alone, diagnosed him as “definitely transgender because he insists that he is and that [the parents’] lack of acceptance is causing his suicidal depression. He should be started on puberty blockers and estrogen to transition.”

This was the first time the 14-year-old boy had ever said such a thing, Cretella noted, yet from this one ER visit, his parents had to fight with the children’s hospital for months against allegations of being “abusive and unsupportive” parents. The family finally found a therapist who helped them set boundaries with their son, and his complaints of feeling trapped in the wrong body have stopped. Even with this outcome, attorneys told the parents they could not sue because experts would side with the ER physician, who was following the “standard of care” guidelines.

The third wave will be here soon, according to Cretella, when schools trigger investigations into parents of children suffering from gender dysphoria, by reporting children “afraid to come out to their parents as their authentic selves.” We can see this wave forming from the multitude of school protocols in the news, such as allowing students from K-12 to choose their gender identity.

The end goal is the same, Cretella said: “removal of a child based on accusations of medical neglect.”

FOIADocuments Provide Evidence

Documents recently obtained from the Rhode Island Family Court in response to a FOIA request give credence to Cretella’s warning. In late 2015—the year before Cretalla first began receiving calls from concerned parents—the Rhode Island Family Court’s Annual Judicial Conference focused on transgendered children. The lead presenter at the judicial conference was Dr. Michelle Forcier.

Forcier “is considered an expert on transgender, queer and questioning youth” and is an associate professor of pediatrics at the Brown University Alpert Medical School. Forcier spoke to attendees at the judicial conference—dozens of state employees, including Court Appointed Special Advocates (CASA) workers, employees of the Department of Children, Youth, and Families (DCYF), and judges—for nearly an hour and a half.

The Rhode Island deputy legal counsel who responded to the FOIA request confirmed that no audio or video recording exists of the conference or of Forcier’s presentation on transgender youth. When asked about the focus of Forcier’s presentation, Judge Sandra Lanni, who organized the conference at the request of the now-retired chief judge of the Rhode Island Family Court, said through a spokesman that “I thought of it as: How do we as judges understand these kids?”

Lanni added that she did not see the doctor’s presentation as any kind of advocacy for a particular course of action and recalled Forcier discussing different approaches to transgender youth, from waiting it out to delaying onset of puberty with hormone treatment, to active counseling and therapy when the behavior is “consistent, insistent, and persistent” with a child who starts early and never stops.

Forcier may not advocate for any “particular course of action,” since her clinic applies, as she put it, “very individualized (not one-size-fits-all) care to each youth and family, in the context of achieving their goals and with their safety, health and short- and long-term well-being in mind.” But her perspective on children suffering from gender dysphoria is one-sided and holds that transgender children must receive opposite-sex health care.

In fact, in a Washington Post interview, Forcier suggests that failing to provide opposite-sex health care is unethical. “How ethical is it to negate a person’s identity — to tell them you know them better than they do?” Forcier asked rhetorically when responding to criticism of the transgender-affirming model. “How ethical is it to deny a person access to medication that is very safe, effective and proven to help persons with gender nonforming/diverse brain/identity and body experiences?”

The AAP Statement

Last fall, the American Academy of Pediatrics (AAP) issued a policy statement similarly recommending this “gender-affirming” approach and providing youth “access to comprehensive gender-affirming and developmentally appropriate health care.” But as Dr. James Cantor explained in his detailed analysis of the AAP policy statement, “almost all clinics and professional associations in the world use what’s called the watchful waiting approach to helping GD children, [but] the AAP statement rejected that consensus, endorsing only gender affirmation.”

Even more appalling than the AAP’s one-sided approach to gender dysphoria is the fact, exposed by Cantor, that the research used to justify the policy “simply did not say what AAP claimed they did.” The materials provided attendees of the Rhode Island Judicial Conference also included this one-sided perspective, which treats “sex” as something “assigned at birth” as opposed to biologically determined. Handouts included a “What Every Attorney Representing Youth Needs to Know” flyer created by the Gay and Lesbian Advocates and Defenders (GLAAD), which included directions such as “Don’t assume someone’s gender identity,” and “Make sure you know your client’s preferred pronouns.”

Another GLAAD handout, entitled “Rights of LGBTQ Youth in Rhode Island,” proclaimed that students “must have access to information and resources about LGBT issues and people, regardless of objecting school officials or parents.” It also said “transgender youth have the right to be identified by the name and pronouns that accord with their gender identities” and “be free from religious indoctrination that condemns or disparages their sexual orientation or gender identity.”

Attendees of the Rhode Island Family Court conference also received copies of two chapters from the book “Transgender Family Law.” These chapters made clear that affirmation and transition are the end goal for therapists, social workers, lawyers, and the courts. Parents affirming a false gender are called “supportive” parents, while those holding to their child’s biological sex are called the “resistant” parent. Even supportive parents are cautioned to move slowly with any transition lest the resistant parent seek and obtain custody.

The CASA and DCYF employees and judges who attended the Rhode Island Family Court conference also left with a handout of contacts who would support children suffering from gender dysphoria and a list of medical providers compiled by Youth Pride, a local LGBTQ youth center. None of the materials provided, however, mentioned support available from the American College of Pediatricians or doctors recommended by that national pediatricians’ organization.

Unlike the AAP, the American College of Pediatricians rejects affirmation of a false sex and believes “ethics alone demands an end to the use of pubertal suppression with GnRH agonists, cross-sex hormones, and sex reassignment surgeries in children and adolescents.” The American College of Pediatricians also recommends an immediate cessation of these interventions and instead maintains that health care services should be anchored to the physical reality of an individual’s biological sex.

All Part of a Pattern

While the one-sided transgender information provided to the CASA and DCYF employees and judges may seem an isolated occurrence, parents need to recognize that such outreach is intentional. While the public relations spokesman for the Rhode Island Family Courts saw Forcier’s presentation as providing “exposure” to the topic of transgender youth, which he explained is typical of the Family Court’s annual fall conferences, several of the FOIA documents provided called the presentation a “training session” and a survey specifically asked whether attendees had learned “best practices.”

Forcier’s comments during a question and answer portion of the national conference for the United States Professional Association for Transgender Health (USPATH), held a little more than a year after her presentation to the Rhode Island Family Courts, provides further insight into the aim of Forcier’s training session. As first reported by 4thWaveNow, “a community of parents & others concerned about the medicalization of gender-atypical youth rapid-onset gender dysphoria,” a clinical psychologist from a Missouri gender clinic asked whether there was precedent for forcing parents to administer puberty blockers.

Forcier replied: “Yeah, there’s no precedent but you can again work with the child protection team for medical neglect. Work with one parent…at least to get things started. And again, you can do some education. We did education with judges in Rhode Island. So we spent a half day with family court judges, basically telling them this is what gender and transgender is…and it’s been deeply helpful with DCYF and our trans population.”

Dr. Johanna Olson-Kennedy, a California physician who specializes intransgendering youth, concurred. “We work really hard to bring both parents in and bring them both on board,” Olson-Kennedy told the questioner, “so it’s not my first line to go to court to get somebody what they need. But it is my second line and I will do it.”

Another session at the end of the USPATH conference exposed the breadth of this approach, when presenters Elizabeth Burke, Matthew Oransky, and Sarah McGrew discussed handling parents who weren’t on board with “gender care.”­­

And the final piece on suicidality is family non-acceptance. This is where you have a family who is saying, no, no, no…and then you realize that actually the family is contributing to some of that negativity at home. So the family is creating a toxic environment. And that’s where we have let the young person know the potential ramifications of calling DHS and saying that this is an unsafe environment. And that we’ve given the family every chance. To learn, to grow. And they’re continuing to be part of the problem. So thankfully this was an important time when I realized it was worthwhile in starting the clinic at children’s hospital to have lots of meetings with the lawyers in risk management. To be able to say, ‘alright. I have the ethicist, I have the lawyer, I have the guru from risk management, I’m gonna sit down and say, I need to describe a case to you and make sure this is actually parents being negligent in the healthcare needs of their child.

Thankfully we’ve had a lot of support in that realm. Because of the trainings we’ve done with [Department of Human Services] DHS workers in Delaware, Pennsylvania, and New Jersey. DHS workers will go and say you’re creating an unsafe environment for your child. And we need to have that stop.…unfortunately staying in that home environment is going to result in a child’s suicide.

Attempts to locate the material provided in these training sessions through FOIA requests to Delaware and Pennsylvania proved unsuccessful––no documents were located in the search for training materials on transgender youth and no communications with, or about, the three presenters (Burke, Oransky, and McGrew) were found. But whatever training these individuals provided seemingly worked because DHS will apparently claim non-affirmation of a child suffering from gender dysphoria is medical neglect justifying the child’s removal from the home.

With transgender activists indoctrinating CASA and child-protective services workers (and potentially judges) on what LGBT activists maintain is the only standard of care for children with gender dysphoria, it will not be long before these troubled children will be removed as a matter of course from loving parents whose only crime is believing there is a better way than lying about their children’s true sex, shooting them up with drugs, rendering them sterile, and eventually mutilating them.

That is unless everyday Americans can come together and stand bravely for the children and against the pressures of political correctness and the spiteful accusations of bigotry. But as Thursday’s failed legislation in South Dakota makes clear, time is running out.

Margot Cleveland is a senior contributor to The Federalist. Cleveland served nearly 25 years as a permanent law clerk to a federal appellate judge and is a former full-time faculty member and current adjunct instructor at the college of business at the University of Notre Dame.
The views expressed here are those of Cleveland in her private capacity.